Tri-Council for Nursing Issues Proclamation on Nursing Civility

In an effort to emphasize how critical civil behavior is to excellence in nursing practice and to outstanding congruent care for all patients, the Tri-Council for Nursing (American Association of Colleges of Nursing (AACN); American Nurses Association (ANA); American Organization of Nurse Executives (AONE); and the National League for Nursing (NLN)), today issued a bold call to advance civility in nursing.

The resolution calls upon “all nurses to recognize nursing civility and take steps to systematically eliminate all acts of incivility in their professional practice, workplace environments, and in our communities.” Tri-Council urges that nursing civility be practiced throughout the US “to establish healthy work environments that embrace and value cultural diversity, inclusivity, and equality.” It makes a point of noting that people of all racial, religious, ethnic, sexual orientation, socio-economic, political, geographic and other differences are to be treated respectfully.

“It’s no secret that acts of disrespect, and other overt or subtle negative emotional behavior create a toxic work environment which contributes to burnout, fatigue, depression and other psychological stresses. Eliminating assaults to anyone’s selfesteem is essential to providing a healthy work and learning environment,” noted G. Rumay Alexander, EdD, RN, FAAN, president of the NLN and Associate ViceChancellor/ Chief Diversity Officer and Professor at the University of North Carolina at Chapel Hill. “The Tri-Council recognizes that instilling an ethic of civility from the very beginning of a nurse’s education and throughout the profession will begin to eliminate the dangers that inevitably arise when it is lacking.”

“Manifesting civility is key to enhancing the patient care experience and ensuring quality team-based care,” said Juliann Sebastian, PhD, RN, FAAN, and chair of the American Association of Colleges of Nursing. “As the most trusted healthcare provider, registered nurses understand the connection between treating patients with respect, establishing open lines of communication, and realizing positive care outcomes.” “AONE is committed to providing nurse leaders with the tools and resources to prevent workplace violence and ensuring the safety of all health care workers and patients. Through its work with the American Hospital Association, AONE is partnering to increase awareness of the issue and support AHA's Hospitals against Violence initiative,” stated Joan Shinkus Clark, DNP, RN, NEA-BC, CENP, FACHE, FAAN, AONE’s president and SVP, THR Chief Nurse Executive at Texas Health Resources.

“Civility forms the foundation of a culture of respect for one another and is nonnegotiable for a healthy, safe and ethical work environment,” Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association, commented. “The ANA has zero-tolerance for any form of incivility, violence, or bullying in the workplace in order to safeguard patients, nurses, and other healthcare team members.”

The Tri-Council identified other potential measurable hazards to health care of incivility, intolerance, and disregard for emotional health: difficulty in nurse recruitment and retention, aggravating the persistent shortage of nurses, and poor communication and teamwork giving rise to preventable errors that risk patient safety. Noting that nurses currently enjoy a reputation as the most ethical and honest profession in the country, the council’s statement articulates a nurse’s ethical obligation to care for others and themselves.